Healthcare Provider Details
I. General information
NPI: 1477170868
Provider Name (Legal Business Name): JOANNA ESTHER RAYGOZA LMFT 149428
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/01/2020
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 SKYPARK DR STE 220
TORRANCE CA
90505-5035
US
IV. Provider business mailing address
3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US
V. Phone/Fax
- Phone: 855-501-1004
- Fax: 310-257-5753
- Phone: 916-576-7900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 149428 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: